Menopause, Mental Health and Me

By Vicky Lott (Harmless Trainer)

The ONS reports that the age specific suicide rate for women is in those aged 45–49. The majority of women will be perimenopausal by age 45 with the average age of menopause being 51. Research carried out by the women’s health organisation Health & Her found that nine in ten women going through menopause transition experienced mental health problems, while one in 10 had thoughts of suicide.

Menopause Effects on the Brain
Many of the psychological symptoms of menopause can occur up to 5 years before the physical symptoms, which is what many physicians still diagnose menopause on. Up until very recently the psychological symptoms have been under-researched and therefore unrecognised, which has led to many women being wrongly diagnosed and treated. While some of the symptoms may resemble depression, anti-depressants don’t always help.

When Oestrogen levels start to fall in peri-menopause this has a direct impact on the key neurotransmitters related to depression: norepinephrine and serotonin. Oestradiol is implicated in several mood-regulating areas of the brain and once the ovaries stop producing it, the adrenal glands take over, but to a much lesser degree. In addition to this, cortisol is produced in the adrenals and will override oestrogen production. Cortisol production increases as we age and more so in women than men. Increased cortisol levels are associated with higher levels of stress, poorer cognitive performance (brain fog) and atrophy of memory-related structures in the brain.

My Story
At the age of 52, I’d been living with various peri-menopausal symptoms which neither myself nor my GP had recognised as such for a number of years – insomnia, aching joints and brain fog to name a few. I’d just put these down to the process of aging which we all go through, right?

Then in 2021 a number of personal and professional challenges took their toll upon my mental health. Whereas previously I’d always been fairly resilient, I just couldn’t bounce back this time and I slipped into quite severe depression.  The anti-depressants I’d been prescribed weren’t suitable for me and although I’d been prescribed HRT by a menopause specialist, my GP blocked issuing the prescription. 

I was facing a future with debilitating physical symptoms. I was also being made redundant and feeling that I had nothing left to offer. Both my children had long since flown the nest and were living their own lives, and I lost hope for the future and considered ending my life.

Once my HRT prescription was issued and I once more had oestrogen in my body, my mental health improved significantly. I’ve since qualified as a licensed menopause champion so that I can help break the stigma around menopause and mental health, and to help others recognise that menopause isn’t just about brain fog and hot flushes.

What Can We Do?
Talk about menopause and don’t be afraid to ask questions. It can be difficult to tie all these symptoms together and relate them to menopause, especially for women in their late 30s or early 40s. Education is key for everyone, not just clinicians. The more we talk and ask questions, the more we can learn and help others.